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This research examines the relationship between pharmaceutical industry advocacy, government regulatory decisions, and market responses in Pakistan’s pharmaceutical sector between 2018 and 2026. It explores how inflation, currency depreciation, and increasing manufacturing costs challenged the existing medicine-pricing framework, leading to growing pressure from pharmaceutical associations for regulatory reform. Particular attention is given to the federal government’s 2024 decision to deregulate non-essential medicine prices. Using a qualitative documentary case-study approach, the research analyzes regulatory policies, industry statements, government decisions, and published market evidence. It evaluates the reported effects of deregulation on medicine availability, pharmaceutical pricing, and patient affordability, while considering alternative regulatory approaches. The study highlights the challenges of balancing pharmaceutical manufacturers’ commercial sustainability with public health and affordable access to essential medicines.